Civic Tech Assessment Resources 5: Sample Survey Questions

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  1. Sample Survey Questions

The following are sample questions for user surveys. Aside from the questions on user demographic characteristics, the wording of the questions reflects a post-only design, which means that the survey would be disseminated to users and their responses would not be compared to self-reported levels of engagement or offline activity before they began platform use. As a rule of thumb, you should adopt the strongest research plan that is feasible. If you are interested in gathering baseline data about your users, you could administer a survey to users when they join the site (pre) and a follow up survey to the same users at later time, e.g., 12 months later (post). The purpose of a pre and post design is to see if outcome scores improve between pre and post exposure to the platform. If you are unable to gather baseline data and have not established control groups, you can still show a correlation between platform participation and effects by analyzing user centric data that links evidence of user participation to evidence of user outcomes from post-only survey responses. You may also be able to compare outcomes for users who join your platform but don’t participate to users who are active, or, if you have a suitably large sample, compare groups with different levels of activity (e.g., no, low, medium, high). User’s responses to direct questions about the impact of the platform should also be linked to platform data on their activity to identify correlations between platform activity and effects.

Demographic Characteristics of Users
(Questions below are examples. Depending on your platform’s goals, consider designing questions so that survey results are comparable with information in existing databases, e.g., U.S. Census, relevant Pew Research Center surveys or Harvard’s Social Capital Community Benchmark survey.)

  1. What year were you born?
  2. Your gender:
    • Male
    • Female
    • Other identification

3. Your race/ethnicity (please check all that apply):

  • White
  • Black or African American
  • Asian
  • American Indian or Alaska Native
  • Native Hawaiian or Other Pacific Islander
  • Hispanic / Latino
  • Other (please describe)

4. What is your nation of birth?

5. What city do you live in? (if applicable)

6. What year did you move to the city you currently live in?

7. If you consider yourself an immigrant, how long have you lived in the United States?

  • Less than one year
  • 1 to 5 years
  • 6 to 10 years
  • More than 10 years
  • Not applicable

8. What is your first or home language? (additional choices should be added as needed)

  • English
  • Spanish
  • Hmong
  • Somali
  • Amharic
  • Arabic
  • Karen
  • Burmese
  • Vietnamese
  • Oromo
  • Khmer
  • Thai
  • Other (please specify)

9. What is the highest level of education you have completed?

  • Less than a high school diploma
  • High school diploma or GED
  • Some college
  • Two year college degree
  • Bachelor’s degree
  • Graduate degree or professional degree

10. Do you own or rent your residence?

  • Own
  • Rent
  • Other (e.g., rent a room, live as a lodger, etc.)

11. What is your total household income? (Please check one.)

  • Less than $10,000
  • $10,000 to $29,999
  • $30,000 to $59,999
  • $60,000 to $99,999
  • $100,000 or more
  • Prefer not to say

12. Do you have dependent children under the age of 18 currently living in your household?

  • No
  • Yes (How many children?)

13. What is your role in your local community? (Please check all that apply.)

  • Resident
  • Parent
  • Student
  • Local business owner
  • Employed by a local business
  • Elected official
  • Local government worker
  • Employed by or a volunteer with a nonprofit or community/cultural organization serving the local area
  • Other (please describe)

Build Place-based Social Capital

1. Has your participation in [platform] made it easier for you to make friends and acquaintances in your neighborhood?

  • No
  • Yes
    If Yes, please specify

2. Has your participation in [platform] affected how often you do any of these things? (Yes/No/If yes, to what degree affected)

  • Said Hi to a neighbor
  • Had a neighbor over to your home
  • Shared or exchanged goods with a neighbor
  • Shared news or community information with a neighbor

3. Has your participation in [platform] affected how much you trust any of the following groups? (Yes/No/If yes, to what degree affected?/ Trust increased a lot/ Trust increased a little/Other)

  • Other people who live in your neighborhood
  • Your local government and elected officials
  • The local media

4. To what extent do you agree or disagree with the following statement: As a result of information or a discussion on [platform] in the last 12 months, I am more satisfied with my community as a place to live

5. In the last 12 months, has your level of involvement in any of these activities INCREASED as a result of your use of [platform]?

  • Shared goods or exchanged favors with a neighbor or local community member
  • Performed local volunteer work
  • Attended a community meeting in which local issues were discussed Contacted an elected official or government office
  • Worked with other residents to make change in the local community Attended a community event, such as a festival, picnic or parade Donated money to a local charity or cause
  • Signed a petition

Increasing Civic Engagement

1. To what extent do you agree or disagree with the following statements: [Scale: Strongly Disagree, Disagree, Neither Agree nor Disagree, Agree, Strongly Agree] As a result of participation in [platform], in the last 12 months…

  • I have been introduced to new ideas or points of view
  • I am more informed about issues that affect my community
  • I discuss local community issues with others more often in person
  • I am more satisfied with my local community as a place to live or work

2. Has your participation in [platform] affected how informed you feel about any of these features of civic life in your community? (Please check all that apply.)

  • Issues that affect your community
  • Your neighbors’/community’s perspectives on local issues
  • Opportunities to become more engaged in the life of your community (e.g., volunteer, contribute to a local charity, run for office)

3. In the last 12 months, has your level of involvement in any of these activities INCREASED as a result of your use of [platform]? [Scale: No, did not increase at all; Yes, increased a little; Yes, increased a lot]

  • Attended a public meeting in which local issues were discussed
  • Contacted an elected representative about a local issue outside of xx
  • Worked with other residents to make change in the local community
  • Donated money to help a local organization
  • Signed a petition
  • Performed local volunteer work for any organization or group

4. Has your participation in [platform] affected whether you did any of these things? (Check all that apply.)

  • Voted in a local election
  • Led a community effort or started a new civic initiative in your community

5. In the last 12 months, did something you saw or read on [platform] lead you to take action of some kind?

  • No
  • Yes
    If yes, please specify.

Promoting Deliberative Democracy

1. [For non-government users] As a result of your participation on [platform], do you know any of your elected representatives better?

  • Yes/No [Specify at which level: local, state, congress, etc. and yes/no for each.]

2. [For government users] To what extent do you agree or disagree with the following statement? (5 point Likert scale: disagree/agree). As a result of my participation on [platform], I prioritized or took action on a particular policy

3. To your knowledge, has the participation of citizens/residents/constituents and public officials on [platform] led to ….(Yes/No for each option)

  • Increased civic engagement by citizens/residents/constituents (either online or offline)
  • Strengthened support for public decision making
  • Engagement from people who are not normally engaged in the political process
  • More open dialogue between citizens/residents/constituents and elected officials
  • More trust between citizens/residents/constituents and elected officials
  • Changes in
    1. Policies and legislation
    2. Budget or spending
    3. Neighborhood plans
  • If yes to any of the above, please give example(s) here_____________

Supporting Open Governance (questions for policymakers/government users

1. How important to you are the following opportunities provided by [platform]? (5 point Likert scale: not important/important). Opportunity to…

  • Inform the public about government issues, resources or policies
  • Help citizens learn about a topic or problem
  • Gather information about citizens’ concerns, needs or values
  • Engage hard to reach populations
  • Learn more about civic tech benefits and challenges
  • Other. Please describe_____________

2. To what extent do you agree or disagree with the following statements? (5 point Likert scale: disagree/agree). As a result of my participation on [platform]…

  • I learned something new about citizens’/residents’/constituents’ concerns, needs or values
  • I learned something new about government issues, resources or policies
  • I fielded questions from constituents that I don’t normally hear from
  • I shared information generated on [platform] with my constituents in other settings (online or offline)
  • I prioritized or took action on a particular issue or policy
  • I engaged with more of my constituents
  • I promoted [platform] with staff and colleagues
  • I am more likely to explore other civic tech platforms and apps that promote open governance

3. To your knowledge, has the participation of citizens/residents/constituents and public officials on [platform] led to changes in ….(Yes/No for each option)

  • Government organization and processes
  • Wider support within government for the practice of open governance
  • If yes to any of the above, please give example(s) here_____________

Fostering Inclusion and Diversity

1. In the last 12 months, has your participation on [platform] INCREASED the frequency with which you interact with…? (Not at all, Increased a little, Increased a lot, N/A)

  • Neighbors of different races and ethnicities
  • Neighbors who were born in a different country (e.g., immigrant versus native born)
  • People who have lived in your neighborhood for different lengths of time (e.g., new residents versus established residents)

2. As a result of information or a discussion on [platform] in the last 12 months…(Five point Likert scale: disagree/agree)

  • I feel that my participation is valued by others on [platform]
  • I have been introduced to new ideas or points of view

Informing Users

1. Has your level of involvement in any of these activities increased as a result of your use of [platform] in the last 12 months? (Not at all, Increased a little, Increased a lot, N/A)

  • Get community news and local event announcements
  • Get information about local businesses, services, and resources
  • Discuss or read other’s views on community issues and happenings
  • Share ideas or get involved in community initiatives
  • Meet neighbors and other community members
  • Help neighbors in need

2. Has your participation on [platform] affected how informed you feel about any of these features of civic life in your community? (Did not affect, Affected a little, Affected a lot, N/A.)

  • Issues that affect your community
  • Your neighbors’/community’s perspectives on local issues
  • Opportunities to become more engaged in the life of your community (e.g., volunteer, contribute to a local charity, run for office)

Increasing Self-Efficacy

1. How much impact do you think that people like you can have in making [local geography] a better place to live? (Please check one.)

  • A big impact
  • A moderate impact
  • A small impact
  • No impact at all

2. Has your participation on [platform] affected your ability to influence decisions in your community? (Please check one.)

  • Yes
  • No
  • Don’t know

Network Tool: Network Health Scorecard


Regular check ups can help network builders track progress and decide what the network needs next. The Network Health Scorecard provides a quick series of questions that can yield a useful assessment of the health of your network - diagnosing strengths and areas for growth.

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